Objective To discuss the practical application effect of the work process oriented teaching model that based on flipped classroom in the teaching of higher vocational Chinese medicines.Method We chose 97 students from Grade 2012 higher vocational Chinese traditional medicine,set them into experimental group (47 students) and comparison group (50 students).The experimental group was applied with the flipped classroom teaching,combined with the teaching mode of working process and the comparison group was applied with the traditional teaching mode from September 2014 to July 2015.At the end of the experiment,through the questionnaire survey,the differences of the experimental group students' autonomous learning ability and problem solving ability were compared between before the experiment teaching and after the teaching.The difference of post adaptation ability of the experimental group and the control group was also compared,and besides,the students' satisfaction degree to flipped classroom combined with working process teaching mode was investigated and analyzed.SPSS 16.0 software was used for statistical analysis,and t test was used to compare two groups' measurement information and count data with chi-square test.Result The score of independent learning ability after teaching in the experimental group was significantly higher than before [(77.50 ± 7.10) vs.(88.51 ± 9.30);t=6.451,P=0.000].However,there was no statistically significant difference in problem-solving capability before and after the teaching[(83.70 ± 2.32) vs.(84.30 ± 2.11);t=1.312,P=0.193].The score of five aspects of the adaptability to work in the experimental group and total score were higher than the comparison group and the difference was statistically significant [work attitude (18.72 ± 2.01) vs.(16.78 ± 3.33),t=3.447,P=0.001;service ability (17.99 ± 1.98) vs.(16.05 ± 2.15),t=4.614,P=0.000;professional ability (18.19 ± 2.46) vs.(15.37 ± 2.79),t=5.267,P=0.000;completion of work (19.01 ± 1.75) vs.(16.88 ± 1.83),t=5.851,P=0.000;strain capacity:(18.33 ± 2.09) vs.(17.01 ± 2.46),t=2.839,P=0.006;the total score of job adaptability (92.24 ± 3.89) vs.(82.09 ± 4.05),t=12.574,P=0.000].Experimental group's satisfaction showed that 91.48％ of students liked the teaching model,87.23％ thought that it improved their learning interest,82.98％ believed that it was beneficial to improving their communication skills.Conclusion Teaching mode of flipped classroom combined with working process helps to improve teaching quality.

Objective To study the influence of dietary test designed by Nutritional Department of Henan Provincial People's Hospital on diabetic inpatients' dietary cognition. Methods A total of 134 diabetic inpatients were selected and tested with standard diabetic meaL Self-reporting of oil, salt, staple food, vegetables and meat intake was evaluated. Nonparametric tests were used for statistical analysis. Results There were significant differences in self-reporting of oil,salt,staple food and meat intake between pre and post test (Z= -4.642, -8.700, -2.218, -5. 528,all P<0.05) ; however,no significant change of self reporting vegetable intake was found ( Z = - 1. 385, P > 0. 05 ). Conclusion Dietary test can significantly change patients' cognition about their daily dietary intake.

Objective To study the effect of P-glycoprotein (PGP) in regulation of penetration of carbamazepine and phenytoin through blood-brain barrier, as to indicating the entry of epileptic drugs into the brain restricted by PGP and deducing the multidrug resistance mechanisms of refractory epilepsy. Methods The microdialysis probe was placed into the cortex of rats, and after systemic injection of carbamazepine and phenytoin, dialysate was collected and the antiepiletic drug concentration in the extracellular fluid of the cerebral cortex was determined by high-performance liquid chromatography (HPLC). Then observing whether the concentration of drugs in extracellular fluid can be enhanced by PGP’s inhibitor verapamil. Results Verapamil significantly enhanced the concentration of carbamazepine in extracellular fluid of the cerebral cortex during 60—90 minutes after injection ((1.74?0.28)?g/ml in 60 minutes and (1.87?0.31)?g/ml in 90 minutes,P

Objective To study the effect of Eclipta alba on learning and memory ability and brain derived neurotrophic factor(BDNF) in brain of Alzheimer's disease (AD) model rats.Methods Healthy adult SD rats were randomly divided into control group,model group,low dosage group and high dosage group.There were 10 rats in each group.The model of Alzheimer's disease was established with subcutaneous injection of D-galactose and microinjection Aβ25-35 on bilateral hippocampus.All rats were treated with saline solution or different dosage of Eclipta alba respectively lasting 8 weeks.Then the ability of learning and memory of AD rats was evaluated by the Morris water maze test.The levels of expression of BDNF in brain were determined by immunohistochemical staining method and Western Blot method.Results The Morris water maze test:the average escape latent period prolonged besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform((34.14± 1.43) s,(33.71±3.82) ％,(3.40±0.70) times) decreased significantly in model group compared with control group((18.83±0.62) s,(41.98±3.96) ％,(5.40± 1.17) times,P＜0.01).The average escape latent period shortened besides the percentage of the swimming time in the target quadrant from the total swimming time and the times across the platform increased significantly in high dosage group compared with the model group (P＜0.01).Immunohistochemical staining and Western blot:the level of expression of BDNF in brain in model group was prominently less than control group (P＜ 0.01).The BDNF level in drug treated groups was prominently higher than model group(P＜0.01).The expression of BDNF increased with the drug dosage increasing.Conclusion Eclipta alba can improve the learning and memory function of AD rats by enhance the expression of BDNF.

Objective The psychometric hepatic encephalopathy scale (PHES),including five psychometric tests,is a standard for the diagnosis of minimal hepatic encephalopathy (MHE) and enjoys predictive value of overt hepatic encephalopathy (OHE).We investigate whether a simplified PHES is as useful as the whole PHES.Methods Seventy consecutive hepatitis B cirrhotic patients without OHE,admitted to our hospital from October 2012 to June 2013,and other 72 healthy volunteers were chosen in our study.PHES was performed in both groups.Expected normal reference value formula were established based on the 5 psychometric tests in healthy controls,and backward logistic regression was performed by eliminating stepwise variables of PHES to get a simplified PHES (SPHES).Then,SPHES was performed on the 70 patients and followed up for a year to detect the prevalence rate of MHE and OHE.Results PHES was easily influenced by age and educational level.In patients with liver cirrhosis,44.29％ patients (31/70) had MHE based on PHES and 41.43％ (9/70) had MHE based on SPHES,without significant differences (P＞0.05).According to the follow-up study,21 patients developed OHE; the number of developing OHE showed no significant difference between MHE patients dignosed by PHES and SPHES (P＞0.05).Conclusion SPHES is as good as PHES in diagnosing MHE and predicting the occurrence of OHE,which consumes less time and is more suitable for clinical screening.

Objective:To investigate the correlation between neutrophil to lymphocyte ratio (NLR) and 30-day clinical outcomes in patients with spontaneous cerebral hemorrhage and whether adding NLR to ICH score improve the accuracy of predicting poor outcomes.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurology, the Second People's Hospital of Hefei from March 2018 to April 2019 were enrolled retrospectively. The demographic and baseline clinical and imaging data were documented. The absolute neutrophil counts and absolute lymphocyte counts within 24 h of onset were obtained and NLR was calculated. At 30 d after the onset of cerebral hemorrhage, the modified Rankin Scale was used to evaluate the outcomes. Good outcome was defined as ≤2, and poor outcome was defined as >2. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline NLR, ICH score and NLR+ ICH score for poor outcomes in patients with spontaneous cerebral hemorrhage. Results:A total of 159 patients with spontaneous cerebral hemorrhage were enrolled, including 106 males (66.67%), age 62.29±15.10 years. Neutrophil count was (7.30±3.95)×10 9/L, lymphocyte count was (1.41±0.67)×10 9/L, and NLR was 6.94±7.66. Baseline hematoma volume was 17.93±25.87 ml, median ICH score 0 (interquartile range 0-1). The outcomes of 60 patients (37.7%) were poor at 30 d. Univariate analysis showed that coronary heart disease, systolic blood pressure, diastolic blood pressure, high-sensitivity C-reactive protein, fasting blood glucose, white blood cell count, neutrophil count, NLR, hematoma broken into the ventricle, hematoma volume, NIHSS and ICH scores in the poor outcome group were significantly higher than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage (odds ratio 1.135, 95% confidence interval 1.092-2.321; P=0.038). The ROC curve analysis showed that the best cut-off value of NLR was 6.679, and the sensitivity and specificity of predicting poor outcomes were 51.67% and 76.77% respectively; the best cut-off value of ICH score was 1.0, and the sensitivity and specificity of predicting poor outcomes were 69.71% and 89.80% respectively; the sensitivity and specificity of the combined application of NLR + ICH score to predict poor outcomes were 74.58% and 82.65% respectively. Conclusions:NLR was independently associated with poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage. Adding it to the ICH score could improve the accuracy of predicting poor outcome.

OBJECTIVETo evaluate the prognosis of cervical intraepithelial neoplasia grade 1 (CIN1) at different follow-up time points in Chinese women and the relationship with high-risk human papillomavirus (HR-HPV) infection.

METHODSBiopsy-confirmed CIN1 women were followed up from cervical cancer screening cohorts established during 1999 to 2008 in Xiangyuan county, Yangcheng county, Qinxian county and Wuxiang county, Shanxi Province.In each follow-up visit, participants were examined by visual inspection with acetic acid, liquid-based cytology and HR-HPV DNA testing. Those with any positive results received colposcope and biopsies. The cumulative incidence rates of CIN grade 2 or worse (CIN2+) and CIN grade 3 or worse (CIN3+), regression rates and persistent rates were calculated using pathological findings as a gold standard. The risks of progression related with HR-HPV were evaluated stratified by baseline and follow-up HR-HPV status.

RESULTSA total of 228, 224, 261 and 105 CIN1 women received the 1-year, 2-year, 6-year and 11-year follow-up exams, respectively. The cumulative incidence rate of CIN2+ among baseline HR-HPV positive women was 4.8% (6/126), 10.7% (16/150), 16.9% (29/172) and 35% (19/55) in the above follow-up visits, respectively, and their risk of progression was 2.7(95%CI:0.3-22.0), 2.9 (95%CI:0.7-12.1), 12.0 (95%CI:1.7-86.2) and 30.6 (95%CI:1.9-493.5) times higher than baseline HR-HPV negative women. Moreover, the cumulative incidence of CIN2+ among women with positive HR-HPV both at baseline and follow-up visit was 11% (6/55), 14% (6/42), 17% (10/60) and 50% (13/26) in the above follow-up visits, respectively.No new CIN2+ cases were found among those with negative HR-HPV both at baseline and follow-up visits.

CONCLUSIONGiven that CIN1 progression is related to HR-HPV infection, different follow-up intervals and strategies for CIN1 should be taken according to HR-HPV infection status.

Aged ; Biopsy ; Cervical Intraepithelial Neoplasia ; Disease Progression ; Female ; Humans ; Papillomavirus Infections ; Prognosis ; Prospective Studies ; Uterine Cervical Neoplasms

Objective To evaluate the effect of doxofylline on pulmonary inflammatory response induced by mechanical ventilation in rats with chronic obstructive pulmonary disease (COPD).Methods Thirty adult male Sprague-Dawley rats,aged 8 weeks,weighing 200-250 g,were divided into 3 groups (n=10 each) using a random number table method:control group (C group),COPD group and doxofylline group (Dox group).Rats were fed in normoxia for 2 months,and normal saline 0.2 ml was injected into the trachea on 1st and 30th days in C group.Rats were exposed to cigarette smoke for 30 min every day,lasting for 2 months,and lipopolysaccharide 200 μg (0.2 ml) was injected into the trachea on 1st and 30th days in COPD and Dox groups.Two months later,rats in each group were anesthetized,tracheally intubated,and then mechanically ventilated.Doxofylline 50 mg/kg was intravenously injected immediately after intubation in Dox group,and the equal volume of normal saline was given instead in C and COPD groups.Pulmonary specimens were taken after 120 min of mechanical ventilation for examination of pathological changes and for determination of wet/dry weight ratio (W/D ratio) and tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) contents (by enzyme-linked immunosorbent assay).Results No significant pathological change of lung tissues was found in C group,and COPD pathological changes were observed in COPD and Dox groups.Compared with C group,the W/D ratio and TNF-α level were significantly increased,and the IL-10 level was decreased in COPD and Dox groups (P＜0.05).Compared with COPD group,the W/D ratio and TNF-α level were significantly decreased,and the IL-10 level was increased in Dox group (P＜0.05).Conclusion Doxofylline can reduce the pulmonary inflammatory response induced by mechanical ventilation in rats with COPD.

Objective:To investigate the arsenic content in internal and external environment of the people in drinking-water-borne endemic arsenic poisoning areas in Shaanxi Province, the status quo of the disease and the management and services of the existing patients, so as to provide a theoretical basis for evaluating the effect of prevention and control measures on drinking-water-borne endemic arsenic poisoning.Methods:From 2019 to 2020, in accordance with the requirements of the "Notice of Shaanxi Provincial Health Commission on Issuance of Monitoring Plans for Key Endemic Diseases such as Kashin-Beck Disease" and "Monitoring Plans for Drinking Water Arsenic Poisoning in Shaanxi Province", investigation was carried out in all villages of drinking-water-borne endemic arsenic poisoning in Mianxian County of Hanzhong City, Shanyang County and Zhen'an County of Shangluo City to understand the operation of water improvement project. One terminal water sample was collected to determine the content of arsenic in water, and permanent population of the whole village who are and/or had been exposed to excessive arsenic water in the past were examined for arsenic poisoning and the disease condition was determined according to the standard of "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015). Five villages were randomly selected, and 50 people were selected from each village. Real-time urine sample was collected to determine the content of urinary arsenic. At the same time, management and services of the existing arsenic poisoning patients was investigated.Results:A total of 13 villages were investigated, all of which had been improved in water quality, and all 13 water improvement projects were operating normally, with arsenic content < 0.01 mg/L. A total of 12 577 people were examined, and 417 cases of arsenic poisoning were detected, with a detection rate of 3.32%. No new arsenic poisoning case and arsenic-related skin cancer case had been detected. A total of 260 urine samples were detected, and the geometric mean value of urinary arsenic (< 0.001 mg/L) was lower than the safety guideline value of human urinary arsenic (0.032 mg/L). The existing arsenic poisoning patients (417 cases) were included in health management and contracted services.Conclusions:Shaanxi Province has reached the elimination standard of drinking-water-borne endemic arsenic poisoning. In the future, more attention should be paid to the management of water improvement project, as well as to strengthen health promotion and management services for existing patients to consolidate the effects of prevention and control.

The hemodynamics of children with congenital heart disease (CHD) often changes during the perioperative period. Unfortunately, the evaluation of cardiac function in children with CHD is mainly focused on the left ventricle. With the further understanding of cardiac hemodynamics, the monitoring of RV function has gradually become an important part of cardiac intensive care department. We totally searched five databases including Pubmed, Embase, Cochrane, Wanfang Med, as well as China National Knowledge Infrastructure (CNKI) and reviewed the clinical research progress of the application of TAPSE in the evaluation of RV systolic function in children with CHD to provide a theoretical basic for the monitoring of RV function before and after operation in children with CHD.